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Tear Osmolarity and Matrix Metallopeptidase-9 in Dry Eye Associated with Sjogren's Syndrome

Korean Journal of Ophthalmology 2020년 34권 3호 p.179 ~ 186
국경윤 ( Kook Kyung-Yun ) - Chonnam National University Medical School Chonnam National University Hospital Department of Ophthalmology

 ( Jin Rujun ) - Chonnam National University Medical School Chonnam National University Hospital Department of Ophthalmology
 ( Li Lan ) - Chonnam National University Medical School Chonnam National University Hospital Department of Ophthalmology
윤현정 ( Yoon Hyeon-Jeong ) - Chonnam National University Medical School Chonnam National University Hospital Department of Ophthalmology
윤경철 ( Yoon Kyung-Chul ) - Chonnam National University Medical School Chonnam National University Hospital Department of Ophthalmology

Abstract


Purpose: To evaluate the correlations between tear osmolarity and matrix metallopeptidase-9 (MMP-9) and dry eye (DE) indices in patients with DE associated with Sjogren's syndrome (SS).

Methods: Sixty-three patients with DE associated with SS who underwent tear analysis were included. DE tests performed were ocular surface disease index, tear break-up time, Schirmer's test, ocular staining score, and tear osmolarity and MMP-9 tests. Correlations between tear osmolarity and DE indices, differences between patients with abnormal and normal tear osmolarity, and those between positive and negative MMP-9 patients were analyzed. Patients were classified into four groups according to tear osmolarity and MMP-9 results, and between-group differences were analyzed (group 1: abnormal tear osmolarity, MMP-9 positive; group 2: abnormal tear osmolarity, MMP-9 negative; group 3: normal tear osmolarity, MMP-9 positive; group 4: normal tear osmolarity, MMP-9 negative).

Results: Mean age of patients was 54.2 ± 13.9 years, and 96.2% were female. Thirty-five patients had abnormal tear osmolarity and 40 patients were MMP-9 positive. DE indices differed between groups with abnormal and normal tear osmolarity (p < 0.01), but not between positive and negative MMP-9 groups. There were 22 patients in group 1, 13 in group 2, 18 in group 3, and 10 in group 4. Compared to group 4, tear break-up time was shorter in groups 1 (p < 0.01) and 2 (p = 0.02). Schirmer's test values in group 1 were lower than those in group 4 (p = 0.03). Ocular staining score was higher in groups 1 (p < 0.01) and 2 (p < 0.05) than in group 4.

Conclusions: Tear osmolarity was correlated with ocular surface indices in DE associated with SS. Combination of tear osmolarity and MMP-9 test results may be helpful to determine the severity of DE associated with SS.

키워드

Dry eye syndromes; Matrix metallopeptidase-9; Sjogren's syndrome; Tear osmolarity
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